Are Latinos Less Satisfied with Communication by Health Care Providers?

Published in: Journal of General Internal Medicine, v. 14, no. 7, July 1999, p. 409-417

Posted on RAND.org on January 01, 1999

by Leo S. Morales, William Cunningham, Julie A. Brown, Honghu H. Liu, Ron D. Hays

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OBJECTIVE: To examine associations of patient ratings of communication by health care providers with patient language (English vs Spanish) and ethnicity (Latina vs white). METHODS: A random sample of patients receiving medical care from a physician group association concentrated on the West Coast was studied. A total of 7,093 English and Spanish language questionnaires were returned for an overall response rate of 59%. Five questions asking patients to rate communication by their health care providers were examined in this study. All five questions were administered with a 7-point response scale. MAIN RESULTS: The authors estimated the associations of satisfaction ratings with language (English vs Spanish) and ethnicity (white vs Latina) using ordinal logistic models, controlling for age and gender. Latinas responding in Spanish (Latino/Spanish) were significantly more dissatisfied compared with Latinos responding in English (Latina/English) and non-Latino whites responding in English (white) when asked about: (1) the medical staff listened to what they say (29% vs 17% vs 13% rated this very poor, poor, or 'fair; p < .01); (2) answers to their questions (27% vs 16% vs 12%; p < .01); (3) explanations about prescribed medications (22% vs 19% vs 14%; p < .01); (4) explanations about medical procedures and test results (36% vs 21% vs 17%; p < .01), and (5) reassurance and support from their doctors and the office staff (37% vs 23% Vs 18%; p < .01). CONCLUSION: This study documents that Latino/Spanish respondents are significantly more dissatisfied with provider communication than Latino/English and white respondents. These results suggest Spanish-speaking Latinos may be at increased risk of lower quality of care and poor health outcomes. Efforts to improve the quality of communication with Spanish-speaking Latina patients in outpatient health care settings are needed.

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